Aims and objectives
Aim:
To discuss types of Invasive Placental Disease (IPD)
To describe the features of US and MRI in diagnosing IPD
To calculate the sensitivity of US Vs MRI with the gold standard intra operative findings
To calculate other statistical parameters by comparing US and MR findings
To see how MRI can be used as a problem solving tool in equivocal cases
Background:
Invasive Placental Disease (IPD) occurs when there is a defect in the decidua basalis,
resulting in an abnormal invasion of the placenta into...
Methods and materials
A retrospective study was conducted from 06/01/ 2014 – 26/07/2015 in which all the patients that were referred to the clinical imaging department in the Women’s Hospital of Hamad Medical Corporation to rule out Invasive Placental Disease (IPD) were selected based on our following inclusion and exclusion criteria:
Inclusion Criteria:
All patients with US,
MRI and Intraoperative findings during this period were included.
Exclusion Criteria:
Patients without US,
MRI or Intraoperative findings were excluded.
True Positives/Negatives and False Positives/Negatives were calculated for US and MRI...
Results
Total 28 patients were assessed with their US,
MR and intraoperative findings.
True Positives (TP):
Patients that were positive for IPD on US or MR and came positive intraoperatively.
True negative (TN):
Patients that were negative for IPD on US or MR and came negative intraoperatively.
False Positives (FP):
Patients that were positive for IPD on US or MR and came negative intraoperatively.
False Negatives (FN):
Patients that were negative for IPD on US or MR and came positive intraoperatively.
US showed:
TP = 20...
Conclusion
According to our study US should remain the first-line imaging modality to diagnose IPD as it has greater sensitivity compared to MRI,
easy accessibility and cost effectivity.
MRI however is a problem solving-tool to assess inconclusive or equivocal sonographic findings,
especially in patients with posterior placenta and morbidly obese patients.
MRI also has greater positive predictive value than US in positive cases of IPD.
Personal information
Dr.
Samra Abid Qureshi
Clinical Fellow Women's Imaging
Clinical Imaging Department
Hamad Medical Corporation
Doha,
Qatar
email:
[email protected]
Mobile: +974-66100898
Dr.
Ashwini Gujrathi
Specialist Women's Imaging
Clinical Imaging Department
Hamad Medical Corporation
Doha,
Qatar
email:
[email protected]
Mobile: +974-33544845
Dr.
Amal Al-Obaidly
Deputy Chairperson-Clinical Imaging
Chief Radiologist - Women's Hospital
Hamad Medical Corporation
email:
[email protected]
Mobile: +974-55559299
References
1.
Lam G,
Kuller J,
McMahon M.
Use of magnetic imaging and ultrasound in the antenatal diagnosis of placenta accreta.
J Soc Gynecol Investig 2002;9:37e40.
2.
Palacios Jaraquemada JM,
Bruno C.
Gadolinium-enhanced MR imaging in the differential diagnosis of placenta accreta and placenta percreta.
Radiology 2000;216:610e1.
3.
Baughman WC,Corteville JE,
Shah RR.Placenta Accreta:Spectrum of US andMR Imaging Findings.
Radiographics.
2008;28:1905-16.
4.
Warshak CR,
Eskander R,
Hull AD,
et al.
Accuracy of ultrasonography and magnetic resonance imaging in the diagnosis of placenta accreta.
Obstet Gynecol2006;108:573–81.
5....